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Preoperative MELD score as a predictor for post hemihepatectomy complications

dc.contributor.advisorLorf, Thomas PD Dr.
dc.contributor.authorAl- Ghamdi, Thamer
dc.titlePreoperative MELD score as a predictor for post hemihepatectomy complicationsde
dc.contributor.refereeSauerbruch, Tilman Prof. Dr.
dc.description.abstractengBackground: As diagnostic techniques and surgical outcomes improve, the rate that hemihepatectomy is performed for various indications will continue to rise. Objectives: To explore the preoperative predictors of postoperative complications following hemihepatectomy. Subjects and Methods: This study is a retrospective analysis of the clinical data of patients who underwent either liver hemihepatectomy or extended hemihepatectomy at the Georg August University Hospital Göttingen during the period 2002 to 2012. The outcomes were either postoperative complications or death of the patient within three months following the operation. A modified classification of surgical complications was used. Preoperative MELD scores, serum AST, creatinine, and bilirubin levels, INR, biometric patient characteristics and intraoperative blood loss were analyzed as predictive factors for post hemihepatectmy complications. Results: 144 patients underwent hemiheptectomy or extended hemihepatectomy dudring the study period. Postoperative complications were reported in 75 patients (52.1%). The most frequent complications were pleural effusion (26.7%), bile leak (21.3%), wound dehiscence (13.3%), ascites and intra-abdominal abscess (6.7%). Six of the patients with complications died (8% of patients with complications). Four patients had hepatic cirrhosis (one macroscopic and three microscopic). Two of the patients with microscopic cirrhosis had no postoperative complications (Grade 1), and one developed a Grade III-A complication. The patient with macroscopic cirrhosis had a Grade I complication. Their MELD scores were ranged between 6 and 10 preoperatively. The overall mortality rate was 6 of 144 (4.17%). The preoperative Meld score was the only significant predictor of postoperative complications. Conclusions: The complication rate following hemihepatectomy remains high; 52.1% of the patients in the current study had at least one complication. The overall mortality rate was 4.17%. A high preoperative MELD score is the only significant predictor of the development of post-hemihepatectomy
dc.contributor.coRefereeOppermann, Martin Prof. Dr.
dc.contributor.thirdRefereeOellerich, Michael Prof. Dr. Dr. h.c.
dc.subject.enghemihepatectomy, MELD score, postoperative complicationde
dc.affiliation.instituteMedizinische Fakultätde
dc.subject.gokfullMedizin (PPN619874732)de
dc.subject.gokfullChirurgie - Allgemein- und Gesamtdarstellungen (PPN619875968)de

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